Cardiac arrest & resuscitation
Percutaneous cannulation is associated with lower rate of severe neurological complication in femoro-femoral extracorporeal cardiopulmonary resuscitation (ECPR): results from the Extracorporeal Life Support Organization Registry
Main findingResult — go to the resultOdds ratio 0.62 95% CI 0.46–0.83Authors' conclusion
Among adults receiving ECPR, percutaneous cannulation was associated with probable lower rate of severe neurological complication, and similar rates of in-hospital mortality, limb ischemia and cannulation site bleeding.
Study context
- Population
- Adults with refractory cardiac arrest (CA) treated with femoro-femoral ECPR, Extracorporeal Life Support Organization registry, January 2008–December 2019
- Participants
- 3,575 adults
- Exposure
- Percutaneous vs surgical cannulation for femoro-femoral ECPR
- Percutaneousn = 2,749
- Outcome
- Severe neurological complication
Methodological detailsinternational registry, multivariable logistic regression
- International registry
- Multivariable logistic regression
Main finding
As reported in the abstract
Odds ratio
0.62
95% CI 0.46–0.83
P = 0.002
By group
Percutaneous vs Surgical
OR 0.62 (95% CI 0.46–0.83); P = 0.002
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| In-hospital mortalityAdjusted | 0.93 (0.73–1.17) | P = 0.522 | |
| 0.512Odds ratio (log scale) |
Proportion undergoing percutaneous cannulation over study period
- Increased from 18% to 89%
- P < 0.001 for trend
Outcomes by center percutaneous experience or center ECPR volume (subgroup)
- Similar results across levels
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Limb ischemiaAdjusted | 0.84 (0.58–1.20) | P = 0.341 | |
| Cannulation site bleedingAdjusted | 0.90 (0.66–1.22) | P = 0.471 | |
| 0.512Odds ratio (log scale) |
Original publication
Percutaneous cannulation is associated with lower rate of severe neurological complication in femoro-femoral ECPR: results from the Extracorporeal Life Support Organization Registry. Ann Intensive Care. Published 30 August 2023. doi:10.
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